In most cases, gum disease is a bacterial infection, afflicting gums and bone around teeth. It may affect one or many teeth, and it grows more serious with time. If left untreated, gum disease will lead to tooth loss and a need for dentures. And according to recent findings published in the Journal of Dental Research, gum disease is much more common than expected—as much as 50% more. In fact, the American Academy of Periodontology estimates that three out of four Americans deal with some form of gum disease, and yet only three percent seek treatment.
Left untreated, gum disease will inevitably take over. The harmful bacteria seep into the gums, destroying teeth, and the infection can spread to other parts of the body and even cause oral cancer or heart disease.
Q: Doesn’t everyone lose his or her teeth eventually?
A: You don’t have to lose your teeth; they were made to last a lifetime. However, the leading cause of tooth loss in adults 35 and older is untreated periodontal disease. That’s why it’s so important to stop the disease from progressing and catch it as early as possible.
Stages of Gum Disease
Gum disease is a broad category used to describe the infection of gums, which may begin almost imperceptibly and yet can advance into damage serious enough to cause tooth loss.
Beginning Gum Disease: Gingivitis
Gum disease begins with gingivitis, where the gums are swollen, red, and may bleed. As the mildest form of gum disease, gingivitis causes little, if any, discomfort and is reversible with the right treatment and oral care.
Q: Is it normal for gums to bleed?
A: No. Bleeding gums are one of several warning signs of gum disease, along with swollen or tender gums, oral sores, gums pulling away from teeth, and habitual bad breath. If you notice these symptoms, you should see a dentist.
Advanced Gum Disease: Periodontitis
However, if untreated, gum disease will progress from gingivitis into periodontitis, a much more serious condition most often seen in adults. The name periodontitis comes from the word periodontal, which means “around the tooth,” and that is where this serious bacterial infection attacks. In patients afflicted with periodontitis, the gums actually pull away from teeth. Plaque spreads below the gum line, producing toxins that cause irritation and an inflammatory reaction that breaks down tissues and bone around teeth. Eventually this means teeth loosen in the mouth and may have to be removed. Along with tooth decay, periodontal disease is one of the most serious threats to oral health.
Methods for Measuring Gum Disease
Dentists use several methods to examine how far gum disease has spread in a patient’s mouth. These tests help determine the best treatment options for an individual person.
- Gum Probing: By examining the appearance of your mouth and gums in the office, a dentist can see more clearly how healthy gums are.
- Signs of inflammation: Essentially, the dentist will be looking for redness, swelling, and bleeding, as those are beginning signs of gingivitis, the earliest and most reversible form of gum disease.
- X-rays: While x-rays don’t show gum tissue, they do reveal bone loss around teeth, which is a major warning sign in the area of gum disease.
Causes of Gum Disease
Essentially, gum disease is caused by bacteria. Everyone has bacteria in the mouth, and these bacteria combine with sugar from foods to create plaque—that sticky, harmful substance that adheres to teeth. But although everyone has oral bacteria, a variety of other factors affect what those bacteria are able to do to the gums, from lifestyle choices to genetics.
It’s undeniable that genetics play a huge role in the way our bodies work, right down to the way the body responds to bacteria. When it comes to gum disease, research shows that about half of the variance in periodontal disease can be linked to genetics. We see it all the time: there are patients who avoid the dentist for decades and don’t practice good oral hygiene yet have no gum disease, and there are other patients who come for regular checkups and meticulously care for their teeth who still battle gum disease.
Q: Can you catch gum disease from someone else?
A: Believe it or not, yes. Research shows, because bacteria that cause gum disease can pass through saliva, it is possible to spread the disease among family members or couples.
Q: Could I be more at risk for gum disease because of my race or ethnicity?
A: As with other infections, gum disease can happen to anyone. However, there are certain races or ethnicities that are more susceptible. African Americans, for example, are especially prone to localized aggressive periodontitis, and both African Americans and Mexican Americans are more likely to deal with periodontal disease than people of European descent.
Smoking and tobacco are well documented as harmful habits for the lungs, but many people are unaware of how using these substances can also affect the mouth. According to a study published in the Journal of Periodontology, smoking is the #1 most influential life habit effecting periodontitis. Furthermore, another study revealed how secondhand smoke from cigarettes increases risk of bone loss (the leading cause of tooth loss) in patients with periodontitis. Smoking has been shown to be a possible cause for more than half of the cases of adult periodontitis in America.
Some medications can affect your oral health. Minocycline, which is often prescribed for treatment of acne or rheumatoid arthritis, can cause gum discoloration. Nifedipine, a drug used to treat high blood pressure, may increase risk for gingival overgrowth, where gums swell and grow over teeth. These examples demonstrate the importance of giving your dentist a full picture of your medical profile because the drugs you take may change your oral health.
A variety of other diseases increase a patient’s risk for gum disease.
- Diabetes: Research shows patients with poorly controlled Type 2 diabetes to be at a higher risk ofdeveloping serious periodontal disease.
- Obesity: According to a recent study, obesity is a significant predictor of periodontal disease. Along the same lines, poor nutrition can weaken the body’s immunity and make it more susceptible to infections like periodontal disease.
- Stress & Depression: Studies have shown a connection between stress and periodontal diseases. In fact, 57% of studies in one literature review showed a clear link between psychological factors (stress, depression, anxiety, etc.) and gum disease. Often, patients with serious depression and/or emotional stress don’t take the time to practice good oral hygiene. Research shows, for example, that caregivers older than 50 years of age who take care of relatives with dementia or hypercortisolemia frequently have higher levels of plaque and gingival bleeding. Their stressful lifestyle wrecks all kinds of havoc on their bodies, including their mouths. Additionally, hormones can play a role in the health of gums. For women especially, this is a concern, as hormonal changes from puberty, pregnancy, oral contraceptives, or even menopause can affect the mouth.
Links to Other Diseases
Not only can other diseases increase your risk for developing gum disease, but also gum disease can increase your risk for developing other diseases. That’s because your body’s response to infection in the mouth connects with its response to infection in other places.
Here are a few examples of other diseases linked to gum disease:
As the leading cause of death in America today, heart disease is a serious matter, the threat of which prompts many of us to go to the gym or to make better dietary choices. Yet beyond diet and exercise, there are other factors that contribute to cardiovascular risk. A recent study shows that patients with periodontal disease have an increased likelihood of developing heart disease. Therefore, another step to take against heart disease is through the simple tasks of good oral hygiene—such as brushing and flossing regularly—to prevent gum disease from forming or progressing.
Research suggests periodontal disease might also increase risk for certain types of cancer for some people. According to one study, men in particular with periodontal disease face a 14% increase of risk in developing cancer compared to men with healthy gums.